| NPI | 1467928705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERENCE KERNAN GRAY President 860-944-4708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2018-10-14 |
| Last Update Date | 2019-09-25 |